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CONTROLLING CHILDHOOD ASTHMA What is Asthma? Asthma is a long-term disease which can be controlled with proper treatment. Unfortunately it cannot be cured. It affects as many as 1 in 5 children and 1 in 10 adults in Australia. It is the cause of many lost school days and a lot of time off work. People with asthma have episodes of shortness of breath which may be brought on or made worse by certain trigger factors. Shortness of breath is due to narrowing of the small airways within the lungs as a result of inflammation and muscle spasm. How do the lungs work? Every breath you take draws air into the windpipe or trachea. The windpipe splits into two further tubes called the bronchi, which then divide into smaller and smaller airways called bronchioles, eventually leading to small air sacs called alveoli. It is in the alveoli that oxygen in the air passes into the bloodstream. At the same time, carbon dioxide produced in the tissues of the body moves from the blood into the lungs and then out of the body. What happens during an asthma attack? Asthma is due to constriction and inflammation of the small airways. In asthma there is a special type of inflammation which narrows the small airways and makes them 'twitchy' and very sensitive to any environmental changes. The airways also become blocked with sticky mucus. During an asthma attack breathing becomes harder, even at rest. There may be a cough or wheezing, which is a musical noise when you breathe. Asthma can also occur at night during sleep. Asthma can vary in severity from mild chest tightness with cough and wheeze during exertion, to a life-threatening attack of severe breathlessness requiring urgent medical treatment. What are asthma triggers? Asthma tends to run in families with asthma, hayfever or eczema. An asthma attack in children is usually brought on by a viral infection of the lungs (a cold or the flu), but attacks may also be brought on by exposure to other triggers such as:
Exercise and emotion (laughter or crying) may also trigger an attack of asthma. You need to discuss the importance of these factors with your child's doctor to work out the best plan to avoid or minimise their role in asthma attacks. What sort of asthma treatments are there? There are two classes of medicines used to treat asthma: relievers and preventers. Reliever medications: (eg VentolinTM, RespolinTM, RespaxTM, AsmolTM, BricanylTM and AtroventTM) are colour-coded blue and are effective in the relief of an asthma attack. These medications have been around for a long time and are safe. They work by causing the muscles around the airways to relax and so relieve the blockage in your airways. Preventer medications: (eg BecotideTM, BecloforteTM, AldecinTM, PulmicortTM and FlixotideTM as well as IntalTM, Intal forteTM and TiladeTM) should be used if your child develops a wheeze more often than every 2 or 3 weeks. These medications are taken regularly each day to prevent the attacks of asthma from occurring. They work on the lining of the lung airways to reduce the irritation from the triggers listed above. Most children only experience mild and infrequent asthma and therefore it is not necessary for them to use preventive asthma medications. What about exercise and asthma? Exercise will induce an attack in most people with asthma, but some children only get asthma attacks with exercise. Some of these children don't recognise this shortness of breath as asthma, thinking that they're just not fit. Exercise-induced asthma may be prevented by using a reliever asthma medication before exercise. The prevention of exercise-induced asthma will allow your child to enjoy sport to the fullest. What is a good Asthma Management Plan? In some circumstances asthma attacks may be predicted (eg exercise), but often the attacks come when you least expect them. When you are having great difficulty breathing and you feel dreadful, it is hard to think straight. This is why it's important for you to think about the possibility of an asthma attack and have a plan of action. An asthma management plan should be discussed with your child's doctor. It should be in writing so that you may refer to it as necessary. This plan will show you when to increase your medication at the first sign of an increase in asthma symptoms and what to do if the attack is severe. Some children over the age of 6 years may find a peak flow meter useful to assess the severity of their asthma. The most important advice is that if your reliever medications are not working, you should CALL AN AMBULANCE it carries oxygen - and go to the nearest hospital Casualty Department. If your symptoms settle quickly, no harm is done, but if your asthma worsens, you are in the safest place. What sort of lifestyle can be expected? A child with asthma should be able to participate in all of the physical activities offered to children without asthma. Asthma should not be considered as something that will hold your child back in life. Many well-known sportsmen and women with asthma have represented Australia at the highest level in cricket, football, swimming, and other sports. By the proper use of their asthma medications and a good healthy lifestyle, their asthma does not stand in the way of achieving world class performances. You should always have your reliever medication handy for the relief of asthma symptoms. Your child's teacher and school nurse should be informed that your child has asthma and be given a copy of the asthma management plan. You should ensure that the teachers understand that early use of a reliever asthma medication is essential during an asthma attack. Often, people in their teens want to believe that they can do without their asthma medications, but this can lead to trouble. The successful people accept they have a problem, deal with it properly, and get on with leading a full and happy life. What can children with asthma expect from good asthma treatment? If your child's asthma is well controlled, he/she will:
The National Asthma Campaign Six Step Asthma Management Plan
Further information For more information to help you control your child's asthma, talk to your doctor, your pharmacist, or contact your local Asthma Foundation. Please Note: This information is intended by The Australian Lung Foundation to be used as a guide only and is not an authoritative statement. Please consult your family doctor or specialist respiratory physician if you have further questions relating to the information provided here.
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East Valley Division General Practice, Victoria,
Australia, Disclaimer |
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